AB0563 “WELL CONTROLLED” SLE PATIENTS – PHYSICIAN PERCEPTION VS PATIENT REALITY
Authors: R. Rex, E. Hettel, V. Strand, S. May
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> SLE patients present significant challenges in the management of their condition. <h3>Objectives</h3> This study aims to uncover differences in physician perceptions and real-world treatment patterns and outcomes among moderate to severely active patients in the EU5 (France, Italy, Spain, Germany, and UK). <h3>Methods</h3> 1,279 moderate-to-severe (M/S) adult SLE patient records were collected in collaboration with 289 EU5 rheumatologists via an online survey platform from November 2021 through January 2022. <h3>Results</h3> 22% of moderate-to-severe EU5 SLE patients in the chart audit were receiving belimumab to treat their SLE. In half of those cases where patients were NOT on belimumab they were not considered good candidates for the therapy. The key reason for not initiating belimumab treatment being that patients were "well-controlled" on their current pharmacologic regimen. Closer inspection of these "well-controlled" patients (n=228) at the chart level revealed clinical aspects that highlight a potential gap in patient care: The majority of SLE patients in the "well-controlled" subset had moderately active disease, but over one-in-ten were classified with severe disease. On average, 40% of "well controlled" SLE patients had one or more flares over the past year. One-third of the "well controlled" patient subset suffers from at least one moderate-to-severe manifestation of their SLE, with musculoskeletal, dermatologic, and renal manifestations being most prevalent. 29% of "well-controlled" patients have at least one moderate-to-severe symptom of their disease. These include pain/stiffness, fatigue, synovitis, malar rash, photosensitivity, edema, fever, and alopecia. Further, one-third of "well controlled" SLE patients are on steroids, with 40% on a higher dose (&gt;5mg/day) to control their disease. The mean overall dosage of the group was 9.4mg/day, a potentially harmful dosage particularly if used long term. <h3>Conclusion</h3> EU5 physicians' perception of "well controlled" SLE may not align with some patients' clinical reality. Use of belimumab or other advanced therapies <sup>[1]</sup> in these cases may lead to improved patient outcomes and less reliance on steroids, which are often associated with adverse effects, even at low doses <sup>[2].</sup> <h3>References</h3> [1]At the time of fielding, anifrolumab had not yet been approved for treatment of SLE in the EU5. [2]European Lupus Society: SLEuro Lupus White Book, 2022 (sleuro.org). "Timely administration of immunosuppressants, either biologics or non-biologics, should be performed for a better control of disease activity coupled with an early steroid sparing effect." <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> Ryan Rex: None declared, Emily Hettel: None declared, Vibeke Strand Consultant of: AbbVie, Amgen, Aria, AstraZeneca, Bayer, Bioventus, Blackrock, BMS, Boehringer Ingelheim, Celltrion, Chemocentryx, Equillium, Gilead, Genentech/Roche, Glenmark, GSK, Horizon, Inmedix, Janssen, Kiniksa, Kypha, Lilly, Merck, MiMedx, Novartis, Pfizer, Priovant, Regeneron, Rheos, R-Pharma, Samsung, Sandoz, Sanofi, Scipher, Setpoint, Sorrento, Spherix, Tonix, Sawyer May: None declared.